Friday, October 17, 2008

It was shaping up to be quite a boring shift. Only a couple hours to go, and nothing very interesting. There must have been a notice in the paper that the super keen medical student (myself) was going to be working a shift in Emerg, because there really could not have been any other explanation for the massive numbers of people showing up in droves with a chief complaint of "I have a runny nose."Then suddenly the night got very interesting. Here's the play-by-play.6:30 pm ::: A call came in from ambulance dispatch, and the unit clerk quickly summoned the doctor and charge nurse to keep them informed: "There's been a massive car accident down in the valley. A minivan and a car carrying six people in total crashed into each other head-on, somehow got entangled to the point where they were attached, and then both went over the side of the bridge, careened down an embankment, ran into a few trees and then burst into flames. We're setting up for massive burns, tree trunk impalements, major trauma and who knows what else. The medevac helicopter will likely take out the most serious victims to the larger hospital in the next city over, so we'll likely get a few of the less severe tramas...but by the sounds of it, even those will be pretty serious. By the time they get them extracted and bring them in, they should be here in about 50 minutes."6:40 pm :::There is a buzz around the department. The night shift MD shows up to start what he had hoped would be another routine shift, and is instead informed about the upcoming chaos, with several curious other ER staff crowding around to hear the briefing. More reports have come in - the area is too heavily forested, meaning the helicopter can't land. All the traumas will be brought in by ambulance to our hospital!!7:00 pm :::The night resident has been paged to show up earlier, the afternoon shift MD (whose shift was just ending) made the decision to stay a bit later, and people are busy in the trauma bay setting up IV bags. The care aides and clerks are suddenly finding solutions to the longstanding province-wide 'no beds in the rest of the hospital' crisis, magically clearing up four beds in emerg in anticipation for the incoming carnage. I'm helping out a lot, too, I'm told, by going to see a patient who had a bookshelf fall on her head. And another runny nose.7:10 pm :::Another report comes in. The meat wagon won't be in with what's left of the survivors for yet another hour; it seems as though the army or search & rescue might have to be called in to access the area. There's even a suggestion that there might even be gunshot wounds if the drivers got into a road rage argument after the dust settled. In the meantime, my patient with the bookshelf falling on her head turned out to only end up having a textbook fall on her head, the rest of the shelf narrowly missing her body. Her friends were quite concerned, and brought her in. Oh, and she also wants me to assess her runny nose.7:20 pm :::The latest from the disaster zone is relayed to the physician: there is an indication that things may not be as serious as they were initially thought. Three of the people walked out of the accident unscathed, but the other three still seem to be pretty serious. No word on the accuracy of the gunshot rumour. For my patients, I continue to prescribe kleenex, one of the few things that I as a medical student can actually dole out, like it's nobody's business. 7:40 pm :::Word arrives - the ambulances are on their way! One is coming Code 3 - lights and sirens - with the major trauma victim. The other two will follow, as they're coming routine, without lights and sirens, as their patients aren't too serious. The afternoon shift doctor figures that she may as well go home, since things aren't as bad as they first seemed.8:00 pm :::Things have somewhat died down, until the first ambulance is heard in the distance bringing in what must be the major trauma victim. A crowd of ER staff instantaneously gathers at the ambulance bay entrance to greet the incoming disaster. Notably absent from the crowd are the seasoned veterans among the emerg staff, and the doctors, who are going about their own jobs. 8:05 pm :::The ambulance has screeched to a halt, and the paramedics are throwing open the rear doors to reveal their mangled cargo. The crowd that gathered utters nearly an audible, collective groan of disappointment as the patient is wheeled out of the ambulance, sitting up on the stretcher, laughing and joking with the paramedic, without so much as a single indication of major burns, tree trunk impalements, or missing limbs or appendages. In fact, the patient has a makeshift splint on one of his legs, and other than that, appears to be completely well. The patient is deemed non-urgent, and the doctor sends me in to see him. He explains that the accident was pretty much a fender-bender that ended up with his car ramming the guardrail. And despite having what might have been a broken leg, he says that it doesn't hurt that much, and that actually the major thing bothering him right now is his runny nose.

Vitum Statisticus

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*Finus Printicus

Updated 7/07.If you have been my patient, identifying information about you will never be found on this blog. If you do think a story here is about you, I can assure you that is coincidental. After hearing about HIPAA and signing confidentiality forms of my own, and reinforced after I was quite stunned to read the news reports and medical blogging community response to a medical bloggers who have gotten in big doo-doo after accusations of breaching a patient's right to confidentiality in their blogs, I've decided to reaffirm that while my hospital and med-school experiences allow me to get an idea of what happens in medicine, those experiences do not end up here as they actually happened. In order to protect the identity of the patients I interact with, and to protect the opportunity for me to continue blogging, any patient and situational information published here (for example, complaints, diagnoses, age, occupation, definitely names, possibly outcome and heck, even gender) is fictional and has nothing to do with the patients I see. Most accounts written on this blog are inspired by real medical experiences but have been changed to the point that they are entirely fictional; if a post reminds you of an experience you had with a doctor, that is coincidental. I have programmed Blogger to give me a reminder to never compromise the identification of patients that I've seen whenever I am about to write a new post. You wouldn't want your personal info being posted on someone's blog in a way that a reader could figure out that it was you, and you wouldn't want to be entirely open with a physician if you knew s/he was just dying to run to his computer and tell the world about your secrets. You are welcome to read this blog as if the events depicted actually happened, since that's probably more exciting, but the patient encounters you read here never did happen.This blog is not meant to be a substitute for consultation with a qualified medical professional. E-mail addresses I'm provided with through e-mails or comments are never distributed, sold, spammed, or abused by me. Contents are indeed copyright: this means they're the author's property, and you need prior express written consent from the author to do any of these: distributing, broadcasting, copying, copying and pasting, transmitting, altering, selling, presenting, and the like. Especially the like.